DR. DENISE RENEE WALLACE (NPI# 1467604678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467604678 |
| Entity Type | Individual |
| Full Name | DR. DENISE RENEE WALLACE |
| Credential | PH.D. |
| Practice Address |
2500 Nutwood Ave Fullerton CA 92831-3104 |
| Practice Telephone | 7148793901 |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2010-11-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235644469 | Denise Elizabeth Wallace | Psychologist | 7310 Woodward Ave Ste 401, Detroit, MI 48202-3165 | 2017-12-11 |
| 1144607938 | Denise Marie Wallace | Marriage & Family Therapist | 1315 Weatherbee Dr., Winston-salem, NC 27103 | 2015-04-30 |
| 1083165443 | Denise Wallace | Rehabilitation Practitioner | 801 E Chapman Ave, Suite #203, Fullerton, CA 92831-3839 | 2016-10-20 |
| 1457754699 | Denise Wallace | Counselor | 661 E Main St, Abingdon, VA 24210-2339 | 2014-10-02 |
| 1497041602 | Denise Michcell Wallace | Counselor | 368 Fell St, San Francisco, CA 94102-5144 | 2011-06-26 |
| 1902040678 | Denise Eileen Wallace | Counselor | 600 1st Ave, Suite 531, Seattle, WA 98104-2216 | 2009-04-26 |
| Street Address |
2500 NUTWOOD AVE |
| City | FULLERTON |
| State | CA |
| Zip Code | 92831-3104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578758892 | Kimberly Ann Jaramillo | Specialist/Technologist | 2500 Nutwood Ave, Fullerton, CA 92831-3104 | 2007-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982169280 | Jennifer Ann Carroll | Counselor | 2246 N. State College Blvd, Fullerton, CA 92831 | 2019-01-31 |
| 1043733736 | Jimmy K Bhatt | Dentist | 1126 E Commonweath Ave, Fullerton, CA 92831 | 2017-07-25 |
| 1447625090 | Kairos Management | Assisted Living Facility | 1621 E. Chapman Ave, Fullerton, CA 92831 | 2015-12-08 |
| 1407251630 | Sam's West, Inc | Technician/Technologist | 601 S Placentia Ave, Fullerton, CA 92831 | 2014-10-30 |
| 1114361813 | Teresa Kyu Thin Khoo | Internal Medicine | 1907 Deerpark Dr Apt 546, Fullerton, CA 92831 | 2013-04-24 |
| 1699020586 | Julia A Bock | Occupational Therapy Assistant | 1240 N Frances Avenue, Fullerton, CA 92831 | 2012-07-17 |
| 1649566225 | The Center for The Treatment of Addiction | Preferred Provider Organization | 104 N. Raymond Ave., A-2, Fullerton, CA 92831 | 2011-06-22 |
| 1366746877 | Leticia Vallejo | Rehabilitation Practitioner | 801 E.chapman Ave, Fullerton, CA 92831 | 2010-12-28 |
| 1083916860 | Angelica Victoria Norman | Counselor | 801 East Chapman Suite 203, Fullerton, CA 92831 | 2010-11-30 |
| 1457683237 | The Paradise | Home Delivered Meals | 659 S Sate College Blvd., Ste. 51, Fullerton, CA 92831 | 2010-02-04 |
| Find all providers in zip 92831 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992302814 | Sheena Gill | Psychologist | 2501 E Chapman Ave Ste 265, Fullerton, CA 92831-3108 | 2020-10-04 |
| 1366000143 | Wel-mor Psychology Group, Inc | Psychologist | 1440 N Harbor Blvd Ste 725, Fullerton, CA 92835-4170 | 2019-06-05 |
| 1134636327 | Michelle Harriman, Psychologist - A Professional Corporation | Psychologist | 1440 N Harbor Blvd Ste 808, Fullerton, CA 92835 | 2018-01-09 |
| 1639693971 | Jack Gershfeld | Psychologist | 2246 N State College Blvd, Fullerton, CA 92831-1361 | 2017-07-28 |
| 1750656815 | Michael A Moradshahi | Psychologist | 1942 Deerpark Dr, Apartiment 103, Fullerton, CA 92831-1525 | 2012-03-21 |
| 1326378738 | Yasamin Farhad | Psychologist | 2601 E Chapman Ave Ste 111, Fullerton, CA 92831-3737 | 2010-01-06 |
| 1124204920 | Robert L Whitcomb | Psychologist | 213 N Pomona Ave, Fullerton, CA 92832-1926 | 2008-01-11 |
| 1841474822 | North Orange County Sleep Clinic Medical Group Inc | Psychologist | 1915 Sunnycrest Dr, Fullerton, CA 92835-3626 | 2007-12-26 |
| 1841405586 | Shannon Eileen Hanrahan | Psychologist | 227 W Santa Fe Ave, Fullerton, CA 92832-1829 | 2007-05-14 |
| 1457424939 | Ann Foster Golay | Psychologist | 1440 N Harbor Blvd Ste 800, Fullerton, CA 92835-4120 | 2006-11-15 |
| Find all providers in FULLERTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.